Background: The successful use of antiepileptic drugs to treat a wide range of nonepileptic disorders led us to evaluate the potential efficacy of carbamazepine (CBZ) in anxiety disorders. Anxiety may be related to the imbalance between γ-aminobutyric acid (GABA) and glutamate neurotransmitters, systems that are also involved in the CBZ effects. We investigated the role of these systems in the ventral hippocampus (VH) and their interactions with the CBZ effect on anxiety-like behavior in rats using the elevated plus maze. Methods: Animals received GABAergic and NMDA agents in a volume of 1 μl/rat, which was injected into the VH (0.5 μl for each side) 60 min after receiving systemic administration of CBZ. The test sessions took place 10 min later. Results: The systemic administration of CBZ increased the percentage of open arm time (%OAT) at the dose of 40 mg/kg, which is representative of an anxiolytic response. Intra-VH injection of the GABA_A receptor agonist muscimol (0.25–1 μg/rat) in the absence or presence of an ineffective dose of CBZ (30 mg/kg) did not show any significant changes in the parameters of anxiety-like behavior. The administration of GABA_A receptor antagonist bicuculline by itself decreased %OAT at a dose of 1 μg/rat, indicating possible anxiogenic effect. The antagonist (0.75 and 1 μg/rat) also decreased CBZ response. A microinjection of NMDA (0.125 and 0.25 μg/rat) decreased %OAT, which was reversed by the administration of CBZ (40 mg/kg). This indicates interaction between the two drugs. However, the NMDA receptor antagonist DAP-5 (1 μg/rat) significantly increased %OAT, but combined with the lower dose of CBZ (30 mg/kg), it did not trigger any response on anxiety-like parameters. Conclusion: Both GABAergic and NMDA systems in the VH play a role in modulation of anxiety-like behavior of rats. The anxiolytic-like effects of CBZ seem to be mediated, at least in part, through an interaction with GABA_A and NMDA systems in the VH.

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Objective:Most coronary artery bypass grafts are done by applying cardiopulmonary bypass, which usually induces unwanted inflammatory reactions and impairs the outcomes. In order to minimize the perilous response of cardiopulmonary bypass, pentoxifylline was getting used orally.Methods:In a prospective, placebo-controlled, randomized clinical trial, 178 coronary artery bypass graft candidates with ejection fraction lower/equal to 30%, divided into two equal groups (pentoxifylline and control), participated in the study. Pentoxifylline patients received 400 mg pentoxifylline 3 times a day for 3 days before operation. The outcomes were compared between groups using student’s t-test, Mann-Whitney U-test, Pearson chi-square, or Fisher’s exact test.Results:Pentoxifylline administration did not significantly affect troponin-T (p=0.68), but it reduced tumor necrosis factor-a (p=0.01) and interleukin-6 (p=0.01). It improved left ventricular ejection fraction significantly (p=0.01). White blood cell and platelet counts, hemoglobin, and hematocrit were not influenced by pentoxifylline. The drug did not affect blood urea nitrogen and creatinine, occurrence of renal failure, cerebrovascular accidents, and in-hospital mortality rate. The need for an intra-aortic balloon pump, cardiopulmonary bypass, and aortic crossclamp times were not affected, either. Pentoxifylline decreased the intensive care unit stay (p<0.001), ventilation time, 10.4 hours in the pentoxifylline group against 14.7 hours in the control group (p=0.01), and the requirement of inotropic agents (p=0.02) and blood transfusion (p=0.01).Conclusion:Pentoxifylline has more beneficial potencies in reducing adverse events after coronary artery bypass graft using cardiopulmonary bypass, than what are known.

Serum level of HbA1c could not be used as a predictor for the development of POAF.

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IntroductionThe use of coronary artery bypass surgery (CABG) with cardiopulmonary bypass (CPB) or without CPB technique (off-pump) can be associated with different mortality and morbidity and their outcomes remain uncertain. The goal of this study was to evaluate the early outcome of on-pump versus off-pump CABG.MethodsWe conducted a retrospective database review of 13866 patients (13560 patients undergoing on-pump CABG and 306 patients undergoing off-pump CABG) at Tehran Heart Center between January 2002 and January 2007. We compared preoperative, operative, and postoperative characteristics between them.ResultsIn-hospital mortality in the on-pump group was 0.8% compared to 0.7% in the off-pump group (P=0.999) and in-hospital morbidity was 11.7% and 6.5%, respectively (OR: 1.533, 95%CI: 0.902-2.605, P=0.114). Postoperative atrial fibrillation was more prevalent in on-pump versus off-pump surgery (6.0% vs 3.0%, P=0.028), however there were no statistical significant differences in other postoperative complications with regard to cardiac arrest (P=0.733), prolonged ventilation (P=0.363), brain stroke (P=0.999), renal failure (P=0.525), and postoperative bleeding (P=0.999). The mean length of stay in hospital (P=0.156) and in ICU (P=0.498) was also similar between the two groups.ConclusionThe results from an Iranian population-based study showed similar early mortality and morbidity of off-pump CABG in comparison to on-pump surgery.

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